Narrowing of colon in newborns

Most of the constipation in the pediatric age belongs to the category of functional disorders. That is, they are not secondary to any organic problem. But there is a small percentage of cases that are secondary to a narrowing in the most distal part of the colon. It is the so-called Hirschprung dise

Most of the constipation in the pediatric age belongs to the category of functional disorders. That is, they are not secondary to any organic problem. But there is a small percentage of cases that are secondary to a narrowing in the most distal part of the colon. It is the so-called Hirschprung disease (EH).

What is the illness of Hirschprung and how it affects newborns

HD (Hirschprung's disease) is a disorder is due to a neurological problem. In particular, cells present in the neural crest of the embryo called neuroblasts do not migrate correctly in this disease. They should be positioned close to the intestine, but they do not. As a result, part of the large intestine does not develop properly, but remains small. Or atrophic, as we say doctors.

This problem affects 1 / 2500-5000 newborns and sometimes is associated with the presence of more complex syndromes. From the clinical point of view, it is delayed in the evacuation of meconium, constipation due to very small stools, marked abdominal distension and poor weight and length gain.

Diagnosis and treatment of Hirschprung's disease in infancy

For its diagnosis, several techniques can be used. As an imaging technique, the opaque enemais the choice, in which we will identify a zone of narrowing in the colon, proximally to which we will see a dilation.

The functional test of choice is called manometry (in which we will detect an absence in the relaxation of the internal anal sphincter when pressing on that area). The diagnosis of certainty will be done through a colonic biopsy, where we will appreciate the aforementioned absence of nerve cells.

The treatment of HD is surgical, and consists in resecting the affected section and joining the remaining healthy sections.